Active NPI
Chalmers Rieger Wood IV, D.D.S.
- Dentist
- Tulsa, OK
National Provider Identifier
1104186113
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 6416
- Practice address
- 3520 E 31St St
Tulsa, OK 74135-1505 - Phone
- (918) 742-2488
- NPI assigned
- May 23, 2012
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 6416 | OK | Primary |
| Dentist | 122300000X | 2012016058 | MO |
Addresses
Primary practice location
3520 E 31St St
Tulsa, OK 74135-1505
Mailing address
3520 E 31St St
Tulsa, OK 74135-1505
Phone (918) 742-2488
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MO
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: No
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20160118000112 | MO | Order and Referring Only - Dentist | 5193973907 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 6416 | OK | MD | Dentist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| University Health Physicians | Past | Accepting new patients | |
| C. Rieger Wood, III, D.D.S., Inc. | Past | Accepting new patients |
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- General Practice Dentistry
- Tulsa, OK
- NPI 1821142852
-
- Internal Medicine Physician
- Kansas City, MO
- NPI 1669456257
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1337731200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1338336000000",
"number": "1104186113",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3520 E 31ST ST",
"city": "TULSA",
"state": "OK",
"postal_code": "741351505",
"telephone_number": "918-742-2488"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3520 E 31ST ST",
"city": "TULSA",
"state": "OK",
"postal_code": "741351505",
"telephone_number": "918-742-2488"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WOOD",
"first_name": "CHALMERS",
"middle_name": "RIEGER",
"name_prefix": "Dr.",
"name_suffix": "IV",
"credential": "D.D.S.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2012-05-23",
"last_updated": "2012-05-30",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "OK",
"license": "6416",
"primary": true
},
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "MO",
"license": "2012016058",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Tulsa, OK
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 30, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.